Intraoral fracture and orthodontic appliance



April 4, 1950 B. F. TOFFLEMIRE INTRAORAL FRACTURE AND ORTHODONTIC APPLIANCE 2 Sheets-Sheet 1 Filed Jan. 25, 1946 IN VEN TOR BENJANHN F. TOFF'LE'MIRE V T TOFZNEYS Patented Apr. 4, 19-50 INTRAORAL FRACTURE AND ORTHODONTIC APPLIANCE Benjamin F. 'ToiflemiraLafayette; cam:

Application J anuary25, 1946; Serial No; 6433279 5 Claims;

Anobiect of my inventionds' to providean" intra-oral fracture' and" orthodontic appliance whichis an improvement'overtheintra-oral fractum-reduction appliance shown in my Patent N o.

234813.77, dated september 6 ;1949. In the "said" patent, I show" abutments secured to anchor teeth by wire staples andAllen-head set screws that have rounded ends f or contacting directly with the -teeth The-axes of thescrews extend 1 toward the-patients' cheeks and' this necessitates the use of the particular type of wrench shown in" Figure 11 ofsaid' patent." The magnetized bit of this wrench extends at right angles to the wrench handle."

Inthe present "invention; the abutments have attaching screws whose axes extend in the direction of the-length of the mouth and the heads" face toward the front of the mouth where they may-be -rnanipulatedby a wrench whose bit axis" coincides with theaxisof the wrench handle:

This-construction"makes"it easier to attachthe abutments" to the" anchor teeth.

A further object "ofmy invention-is toprovide a device of-the typede'scribed 'in' which the abutment and tooth engagmg'band are madeintegral or connectible to each other byscrews, to facilitate anchoring the abutment to the tooth: The" abutment is formed into two halves,.each half being permanently secured to' an end of. the" tooth-engagingband'; The two' halves may be drawn together by a screw' after the band has I been slipped around atooth'and the screw willtig'hten-theband on the toothso theabutm'ent" will 'be rigidly connectedthereto. This does away withthescrew that abuts the tooth'as shown in said patent; Theintra-oral jaw fractureappliance is readilyapplied'to thejaw'and easy to adjust.

and retention as well as in jaw fracture work;

'I'he invention'differs from said patent in'that it is especially designedto take care of the isolated, displaced and anatomically inaccessible teeth that'have' hitherto (been' so diflicult to con-- These teeth are often'-firmly*'anchored to" a fragment of viable bone and are-consequently trolz of considerable potential value in the reduction and fixation oi the 1 involved fragments? With my present device,:it is merely necessary to slip the adjustable band over the desired tooth and tighten the band by rotating'th'espanner bolt;

Where other teeth" are: more ready of access; the:

It may beused with equal "facility and efiici'ency in-the field of orthodontic adjustment fixation blocks or abutments shown in" said patent cambe usedv since' theyare interchangeable with the abutmentszset :forthiin theapresent case;

Other objects and" advantages will appearinthe followingjspecification, and the novel features 1 of thedevicewillbe "particularlyipointedout in r the appended claims.

Mydnventidrr is illustrated in the accompanying drawings forming a part" of this application;

in which Figure 1 is a-side elevation' of the'upperend' lower jaw*showinggmy-abutments and bars-operativelyapplied theretoand interconnected by elasticbands';

Figure 2*is an' isometric viewof the abutment" and the band;

Figure 3' is a view 'sliowing the abutment an-d band in' an inverted position" "from" that shown in Figure 2} Figure 415 a side elevation" of the spanner screw v and shows a retaining pin in section;

Figure 5is" a tOpfplanr'view-of' the: combined abutmentand band :1:

Figure 6 is a transverse section taken along the Figure isan isometric view of an archbar used irrconnection with? the abutments;

Figure 8" is a -view similar tofFigure 1 arwlil'lu's trates a modified"? form of abutment and arch bar Figure 9 is an isometria-view of the modified abutment and band;

. Figure 10 'isan isometricview of the Combined abutment and band, these being 'shown'inverted" from that illustrated. in Figure 9;

Figure 11' is'" a" side elevation "of the? spanner bolt;

Figure 12 is "a 'top' plan viewof "the combined abutment and band, the "abutment being "shown in section. to r illustrateithe spanner bolt;

Figure 13 is attransversesection taken along the linetXIII-XIII of Figure 12; and,

Figure14is,'arr..isometric view'of a modifiedv form ofarclrbar;

whilerh'aveshown'only the preferred forms of my" invention: it should be'und'erstoocl that" various changes or modifications may be made within the scope of 'th'eappendedclaimswithout departing from thefspirit and scope of the in' vention;

In carrying foutiny invention, 1' provide an abutmentcomposed of two'halves indicated gen- "erally at Al and AZL A bandB hasits ends'permanently" connected to the abutment halves as illustratedin' Figures '5 and" 6: The abutment half 'AI has abore I thereinfor rotatably receivingi'the headTof "aspanner screw ishown-at C in Fi'gure i. The sp'anner screw "has an annular 3 groove 3 formed therein and this groove slidably receives a pin 4 which is inserted in the abutment half Al, as clearly shown in Figure 6.

The other abutment half A2 has a threaded bore 5 therein and this bore receives the threaded end 6 of the spanner screw C. The head 2 of the screw C is of the Allen-head type, which means that the head has a non-circular recess 1 therein, see Figure 3, for receiving a non-circular bit. A rotation of the Allen-head screw C in one direction will draw the two abutment halves Al and A2 toward each other and an opposite rotation will move them away from each other.

Figure 6 shows the band B slipped over an anchor tooth D. A tightening of the band '3 about the tooth is accomplished by rotating the Allenhead screw C. It will be noted from Figure 1 that the heads of the Allen-head screws C face toward the front of the mouth and this permits the screws to be readily rotated in a direction for tightening the bands about the anchor teeth, or for loosening them. Figure 1 shows the lower jaw E fractured at 8. One of the combined abutments and bands is secured to the anchor tooth D disposed on one side of the fracture and another combined abutment and band is secured to a second anchor tooth D disposed on the other side of the fracture. Each abutment half Al and A2 has aligned grooves 9 and ill, respectively, therein, and these grooves receive an arch bar shown at F in Figure 1. The arch bar has integral fingers ll extending from one edge as clearly shown in Figure 7, and the bar is mounted in the grooves 9 and 10 of the two abutments so that the fingers l I will extend downwardly.

The arch bar is securely clamped in the grooves 9 and ill by Allen-head set screws l2 and 13, see Figures 2 and 6. With this construction the arch bar is rigidly secured to the anchor teeth and will hold the two ends of the broken jaw in proper registration so that healin will be rapid.

Figure 1 shows the upper jaw G provided with combined abutments and bands rigidly secured to anchor teeth H and H. In this instance, the grooves 9 and I0 face upwardly and receive a second arch bar F whose fingers II also face upwardly. Elastic bands M are connected to the fingers of the two arch bars F and extend in diagonal directions so as to urge the teeth of the lower and upper jaws into the proper occlusal plane.

In Figures 8 to 14, inclusive, I show a slightly modified form of the invention. In this form of the device the abutment halves J l and J2 are provided with bores l5 and I6, respectively, that have non-circular and tapered recesses I54; and [6a, respectively. A spanner bolt K of the shape shown in Figure 11 has its shank I! received in the bores l5 and I6 and its non-circular and tapered head l8 snugly received in the recess lBc. A threaded end IQ of the shank receives an elongated non-circular nut and Figure 12 shows the nut bearing against the face 2| of the abutment J I rather than being received in the recess The purpose of the modified form of abutment is to permit the abutment and band L to be attached to anchor teeth on either side of the upper or lower jaws as shown in Figure 8. Either abutment half J i or J2 may face forwardly when the device is attached to the anchor teeth and the spanner bolt K is fed through the aligned bores I5 and i6 so that the nut 20 will face toward the front of the mouth where it maybe readilymanipulated for tightening the abutment to the anchor teeth or for freeing it therefrom. Either abutment half can receive the spanner bolt head and this is the principal difference between the modified form and the form shown in Figures 1 to '7, inclusive. Figure 8 shows the abutments extending in the same direction even though attached to the teeth of the upper and lower jaws. If additional elastic tension is desired, the abutments on the teeth of the lower jaw may be turned upside down so the lower arch bar M will be disposed a greater distance from the upper arch bar M, than shown. The elastics 24 will be stretched to a greater degree. The bolts K on the lower abutments can be reversed so the nuts 20 will face forwardly.

It is also possible to do away with soldering the band to the abutment halves. I have shown in Figure 12 how the ends of the band L may be secured to the abutment halves by screws 22 or other suitable fastening means. This will permit a continuous stainless steel matrix band material, as now procurable on the market, to be used at the discretion of the operator. The band material may be cut into suitable lengths and then secured to the abutment halves by set screws. If additional rigidity is desired, the abutment halves may have grooves therein for receiving the ends of the band and then Allen-head set screws can be used for securing the band ends in the grooves.

The arch bars M shown in Figures 8 to 14, inclusive, have their integral fingers 23 bent into the shape of hooks. The hook-shaped fingers 23 receive elastic bands 24 that urge the teeth of the upper and lower jaws toward the occlusal plane. The arch bars are slid into the slots of the fixation blocks or abutments and the parts are brought into normal, functional relationship and occlusion before tightening the Allen-head set screws which immobilize the fracture arch bars and keep all structures in their normal position during the healing process.

For those cases requiring gradual elastic reduction, one of the set screws is left in a loosened state until after the rubber bands have brought the fragments into position. It then is merely necessary to tighten the Allen-head set screw in order to lock the parts in their normal state. The arch bar serves as an alignment bar in the case just cited, yet permits movement in an anteroposterior plane, aided by the steady and gradual elastic traction of the rubber bands. Elastic traction is needed in those cases where it is necessary to induce muscle fatigue and overcome trismus and antagonistic displacement. Then, too, it is very effective on those cases that have gone untreated for some time, resultin in a temporary callus being established between the displaced fragments.

Figure 6 shows the pin 4 received in an opening that terminates in the bottom of the groove 9 in the half A. It is possible with this construction to remove the pin if necessary so as to free the screw C and permit it to be fixed or a new one substituted.

I claim:

1. In combination, a fixation block formed of two halves, a tooth encircling band having its ends secured to the halves, the halves having aligned bores, a spanner screw rotatably received in the bores, said screw having a head with an annular groove disposed near the head, a pin carried by one of the halves and being slidably received in the groove for preventing longitudiends secured to the halves, the halves having.

aligned bores, a spanner screw r-otatably received in the bores, said screw having a head with an annular groove disposed near the head, a pin carried by one of the halves and being slidably received in the groove for preventing longitudinal movement of the screw with respect to the half, the bore in the half not provided with the pin being threaded, said screw having a threaded portion received in the threaded bore, said halves having aligned arch bar receiving grooves, the pinterminating at the bottom of one of the grooves, whereby the pin may be readily removed. v

3. In combination, a fixation block formed of two halves, a tooth encircling band having its ends secured to the halves, the halves having aligned bores, a spanner screw rotatably received in the bores, said screw having a head with an annular groove disposed near the head, a pin carried by one of the halves and being slidably received in the groove for preventing longitudinal movement of the screw with respect to the half, the bore in the half not provided with the pin being threaded, said screw having a threaded portion received in the threaded bore, said halves,

having aligned arch bar receiving grooves, an arch bar receivable in the grooves, and clamping screws carried by the halves for securing the arch bar rigidly to the halves, said arch bar having integral fingers for receiving rubber bands.

4. In combination, a fixation block formed of two halves, a tooth-encircling band having its ends removabl secured to the halves, the halves having aligned bores with tapered non-circular recesses, a spanner bolt receivable in the bores and having a tapered non-circular head snugly received in one of the recesses for preventing rotation of the bolt, and a nut screwed upon the threaded portion of the bolt and contacting the half not receiving the bolt head, whereby a rotation of the nut in one direction will tighten the band and block rigidly to a tooth.

5. In combination, a fixation block formed of two halves, a tooth-encircling band having its ends removably secured to the halves, the halves having aligned bores with tapered non-circular recesses, a spanner bolt receivable in the bores and having a tapered non-circular head snugly received in one of the recesses for preventing rotation of the bolt, a nut screwed upon the threaded portion of the bolt and contacting the half not receiving the bolt head, whereby a rotation of the nut in one direction will tighten the band and block rigidly to a tooth, said halves having aligned arch bar receiving grooves, an arch bar receivable in the grooves, and clamping screws carried by the halves for securing the arch bar rigidly to the halves, said arch bar having integral hook-shaped fingers for receiving rubber bands.

BENJAMIN F. TOFFLEMIRE.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,114,624 Meier Oct. 20, 1914 1,471,785 Fernald Oct. 23, 1923 1,638,006 Aderer Aug. 9, 1927 2,379,011 Laskin June 26, 1945 

